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'Production line' surgery used in India will 'cut NHS costs

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The head of the watchdog said the NHS cannot survive without making radical changes - including the use of more private firms to fulfill its contracts, and cheaper models of medical care imported from overseas. David Bennett, the chief executive of Monitor, which regulates competion in the health service, said barriers will be lifted, to encourage more companies to compete for NHS work and force its costs down.

Last night Labour described the policy as one of “market madness” with Andy Burnham, shadow health secretary, saying the message exposed a “hidden Government agenda” that the health service was being softened up for privatisation. Mr Bennett said the health service should consider adopting methods such as those used in India, where a production-line approach is used for some surgery, at one sixth of the cost of British systems.

Without such radical changes, the health service would fail to close a £30bn funding gap forecast for 2021, he said. Mr Bennett said it was “astonishing” how slow the NHS was to adopt innovation, and that more private companies needed to be brought in to “inject different ideas” about how best to provide care.

He said a study of global health systems suggested that the Indian model was one of the most interesting, and could bring a “huge step forward” in improving NHS productivity. Under the Indian system, more than 300,000 cataract operations a year are carried out using a production-line method, in which qualified surgeons only carrry out the most complex part of the procedure, with simpler tasks given to cheaper staff.

Mr Bennett said that even after adjustments to account for relative costs in each country, the costs worked out one sixth of those of the NHS, while outcomes were superior, with lower infection rates. “This is not poor quality care - this is genuinely a fundamentally different way of doing it,” he said. “They have redesigned the whole process so the surgeon is basically dong nothing but operating on the patients.”

In a report published today, the regulator said that if the same approach was introduced in Britain for cataracts, cardiac surgery and orthopaedic procedures, more than £1bn a year could be saved. Mr Bennett said: “I think a lot of creativity and imagination is needed to work out how you take those sorts of ideas and bring them into this country.”

He said he did not think the health service would introduce radical reforms unless under pressure from new competitors. “I do believe that one of the better ways of trying to get significant change is to inject some different ideas - which probably means sometimes it’s useful to have somebody else doing it,” he said. “If you have got a player outside the NHS with what looks like a good idea that means better quality and may be more efficient and they feel unfair barriers have been put in their way then we will seek to remove those barriers.”

The regulator said a major programme of hospital reorganisations, and closures of some units, would be required to tackle a looming financial shortfall, but would go nowhere near solving the problem, which required new entrants to compete for NHS contracts and force down costs. He said it would be “absolutely wrong” if private firms did not get the opportunity to bid for NHS work, and that too often they were denied contracts because the NHS prefered to stick to established practices.

Mr Bennett said: “If they have got a better service to offer they should get the opportunity to demonstrate that they can do that. It would be absolutely wrong not to accept that. We need every bit of help we can get.” Mr Burnham said: “This will send a shiver down many a spine. It confirms the suspicion many people have that David Cameron is softening up the NHS for privatisation.” He said market systems cost rather than saved money, and would not make the NHS more efficient.

“This is the Government’s hidden NHS agenda that Ministers don’t dare admit. It is this market madness that has got to go.” A Conservative health spokesperson said those comments were “shameless scaremongering; there is absolutely no Government policy to privatise NHS services. Our only consideration is getting the best possible services for patients - regardless of who provides it.”

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